Pneumonia: the results of the study warn experts about the current treatment

For a long time, doctors thought that bacteria were the cause of pneumonia – Kenya's main child killer, who reported 21,584 deaths in 2017 alone.

But a study spanning more than 30 years shows that 61% of cases of the disease are caused by viruses, which again triggered a debate among experts on the opportunity for the Ministry of Health to review its policy and his treatment of pneumonia.

The PERCH study (Pneumonia Etiology Research for Child Health), a million-dollar research conducted in Kenya and six other countries heavily affected by the disease, revealed that the viruses were at risk. origin of most serious cases.

Respiratory syncytial virus was the major pathogen (31%) at all sites of the 30 pathogens. The bacteria, which are removed from the body by antibiotics, are causing only 27% of pneumonia, the study showed. However, guidelines approved by the World Health Organization in Kenya recommend the use of antibiotics to treat pneumonia.

The study included 4,232 children aged from one month to 5 years, hospitalized for severe pneumonia, as well as 5,325 others from the same communities who were not ill.

Kenya, Mali, The Gambia, South Africa, Thailand, Zambia and Bangladesh were chosen because of their different characteristics that could influence the causes of pneumonia.

Dr. Ambrose Agweyu, a researcher and expert in pneumonia from the Kenya Medical Research Institute (Kemri-Wellcome Trust), told the Nation: "I do not foresee Kenya abandoning the use of antibiotics in children with pneumonia despite this study."

Dr. Agweyu explained that because of the diagnosis of pneumonia, it was extremely difficult for health professionals to know what the cause was and to know for sure whether antibiotics should be given or not.

Pneumonia is manifested by a cough accompanied by a difficult breathing as a result of a problem in the chest.

Dr. Agweyu added: "Unlike the PERCH study that had advanced technology to isolate and find out" it's the pathogen that causes this disease, "many institutions health do not have this equipment and the caregiver will not deny a patient seriously ill children's antibiotics, knowing that there is a 30% chance that this has been caused by a bacterium. "

The expert added that there were cases of pneumonia caused by viruses whose bacterial complications were aggravated. In addition to the complexity of the disease, the current guidelines used by Kenya's hospitals do not help either. Kenya revised its WHO approved guidelines on pneumonia last year, 30 years after they were developed.

Professor Kim Mulholland, a pediatrician who has been working on data badysis at the London School of Hygiene and Tropical Medicine, said he was concerned about WHO's simplification of the management of children with pneumonia. in these two categories of 'low risk' – to be treated at home – and 'high risk' – to be treated at the hospital.

The Ministry of Health did not respond to the NationQuestions about the guidelines.